Association between diabetic control and progression of monoclonal gammopathy of undetermined significance to multiple myeloma

IF 13.8 1区医学 Q1 HEMATOLOGY

Blood Cancer Journal Pub Date : 2026-08-03 DOI:10.1038/s41408-026-01592-x

Lawrence Liu, Byron Sigel, Mei Wang, Nikhil Grandhi, Martin W. Schoen, Kristen M. Sanfilippo, Kenneth R. Carson, Murali Janakiram, Tzeyu L. Michaud, Graham A. Colditz, Theodore S. Thomas, Su-Hsin Chang

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引用次数: 0

Abstract

Diabetes Mellitus (DM) is a risk factor for multiple myeloma (MM), but the relationship between diabetic control and risk of progression to MM in patients with monoclonal gammopathy of undetermined significant (MGUS) is unclear. We conducted a retrospective cohort study of US Veterans diagnosed with MGUS from 10/1/1999-12/31/2023 with prior DM. MGUS and MM diagnoses were confirmed using published natural language processing-assisted models. The exposure was time-varying glycated hemoglobin (HbA1c) > 7% during the follow-up (time of MGUS to MM, death, or being censored on 4/15/2025, whichever occurred first). The outcome was time from MGUS to MM. The association was estimated by multivariable-adjusted hazard ratio (aHR) using a Fine-Gray subdistribution hazard model with death as a competing event, adjusted by inverse probability of treatment weighting (IPTW). Among 11,061 patients with DM, HbA1c > 7% was associated with increased progression risk (aHR 1.15; 95% confidence interval [CI] 1.01–1.32). This association was stronger in the subgroups of Type-2 DM (T2DM) with insulin use (n = 7070; aHR 1.46; 95% CI 1.19–1.78) and non-use (n = 3724; aHR 1.42; 95% CI 1.14–1.77) throughout follow-up. For patients with T2DM and MGUS, poorly controlled diabetes may be associated with progression risk to MM. Future studies are needed to confirm this relationship.

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糖尿病控制与多发性骨髓瘤单克隆γ病进展之间的关系

糖尿病（DM）是多发性骨髓瘤（MM）的危险因素，但在未确定显著性单克隆γ病（MGUS）患者中，糖尿病控制与进展为MM的风险之间的关系尚不清楚。我们对1999年10月1日至2023年12月31日期间诊断为MGUS的美国退伍军人进行了回顾性队列研究，这些退伍军人既往患有糖尿病。MGUS和MM诊断使用已发表的自然语言处理辅助模型进行了证实。随访期间暴露时变糖化血红蛋白（HbA1c）为bb0.7% （MGUS至MM、死亡或在2025年4月15日被审查的时间，以先发生者为准）。结果是从MGUS到MM的时间。通过多变量校正风险比（aHR）估计相关性，使用细灰色亚分布风险模型，将死亡作为竞争事件，并通过治疗加权逆概率（IPTW）进行调整。在11061例糖尿病患者中，HbA1c bb7%与进展风险增加相关（aHR 1.15； 95%可信区间[CI] 1.01-1.32）。在随访期间使用胰岛素（n = 7070; aHR 1.46; 95% CI 1.19-1.78）和未使用胰岛素（n = 3724; aHR 1.42; 95% CI 1.14-1.77）的2型糖尿病（T2DM）亚组中，这种相关性更强。对于T2DM和MGUS患者，控制不良的糖尿病可能与MM的进展风险相关。需要进一步的研究来证实这种关系。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Blood Cancer Journal ONCOLOGY-

CiteScore

16.70

自引率

2.30%

发文量

153

审稿时长

>12 weeks

期刊介绍： Blood Cancer Journal is dedicated to publishing high-quality articles related to hematologic malignancies and related disorders. The journal welcomes submissions of original research, reviews, guidelines, and letters that are deemed to have a significant impact in the field. While the journal covers a wide range of topics, it particularly focuses on areas such as: Preclinical studies of new compounds, especially those that provide mechanistic insights Clinical trials and observations Reviews related to new drugs and current management of hematologic malignancies Novel observations related to new mutations, molecular pathways, and tumor genomics Blood Cancer Journal offers a forum for expedited publication of novel observations regarding new mutations or altered pathways.